Midwives must be licensed under new law

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Capital News Service
LANSING — Michigan midwife associations were pleased when Gov. Rick Snyder signed new midwife licensing legislation into law at the beginning of the year.
Midwives are trained to assist women in childbirth. They help with delivery as well as provide prenatal and postpartum care. Michigan has 31 certified professional midwives currently registered with the state, according to the North American Registry of Midwives.
To further protect the safety of mothers, some midwifery advocates lobbied for such a licensing law for nearly six years, according to Stacia Proefrock, president of the Michigan Midwives Association and a certified professional midwife at Trillium Midwifery in Ypsilanti.
The law requires midwives to apply for a license with the newly created Michigan Board of Licensed Midwifery, operating through the Department of Licensing and Regulatory Affairs (LARA).
The push for licensing legislation was in response to inconsistencies in midwifery education and training. Establishing licensing rules will protect mothers from instances where a midwife may not have received adequate training, some advocates said. According to Proefrock, these rules will also help to protect the legality of the profession.
In mid-April, Snyder appointed the board’s 12 members — seven midwives, a certified nurse midwife, a gynecologist, a pediatrician and two members of the general public. Their appointments are subject to Senate approval.
According to Michael Loepp, a LARA communications representative, the board will establish rules for licensing and education. The department is in the process of providing members with information.
After establishing rules, board members may only approve licenses to applicants who complete an educational program at a midwifery school that’s accredited by the Midwifery Education and Accreditation Council, according to the new law. Many midwives who seek certification complete an apprenticeship before attending school, according to Proefrock.
Applicants must also be considered certified professional midwives by a board-approved certifying agency, pass a midwifery exam and pay licensing fees. The application fee is $450, until the licensing department receives over $23,000 — then it will drop to $75. The annual licensing fee is $200.
Proefrock said she believes the legislation is successful because it allows for legal midwifery practice without restrictive guidelines.
Deborah Fisch, vice president of Friends of Michigan Midwives, said her organization is also pleased with the new law.
Friends of Michigan Midwives was a member of the Coalition to License Certified Professional Midwives, among other associations that  banded together to lobby for licensing legislation. The Michigan Midwives Association was also a member.
“When you’re hiring any kind of professional, you want to know that there is some kind of standard for their skill set,” Fisch said. “We understand in all professions there is a bad apple, and we want to keep consumers safe.”
According to Emily Dove-Medows, president of the Michigan Affiliate of American College of Nurse-Midwives, licensing can ensure safety because it holds midwives accountable, just like other health care providers.
The American College of Nurse-Midwives represents certified nurse midwives, who collaborate with physicians in a clinical setting. 
As a certified nurse midwife, Dove-Medows will not be affected by the new law, which pertains only to certified professional midwives and direct-entry midwives who are not always certified. But she said her organization supports the legislation because it aims to protect the public.
“If I practiced in a way that was inappropriate, I would be held accountable for that,” Dove-Medows said, adding that professional midwives should be held to the same standard.
Since the licensing legislation was introduced in the state Legislature in 2015, Proefrock said she has noticed more practicing midwives in the state.
“As president, I have become aware of several midwives who have moved into the state recently,” Proefrock said. “Also, I have been contacted by three student midwives who are looking into moving into the state after they graduate.”
She said she thinks the law will make her profession more stable, and because of that, more desirable.
“It allows for women who are considering a career in midwifery to know that the profession they’re choosing to practice is legal (and) will continue to be legal,” Proefrock said.
With licensing, midwives “can establish a practice, they can invest in a physical location to do their work, make investments in hiring employees or taking on students, and know that the government isn’t going to come in and shut down their practice for no reason,” she said.
Despite support from midwifery associations, some health care professionals remain opposed to the new law.
Abigail Nobel, a health policy nurse and advocate for health care freedom from Dorr, said she has opposed the legislation since it was introduced. She said it takes away a woman’s ability to choose who she would like to assist her delivery.
“I think that it takes the determination of what is quality away from the mother and family and puts it with the state,” Nobel said. “I really think it’s a pity that some professional midwives made the practice of direct-entry midwives illegal. It seems unjust to me.”
For more information on Michigan midwifery, visit michiganmidwives.org.

Editor’s note: This story has been updated to clarify the type of midwives represented by the American College of Nurse-Midwives; to correct Abigail Nobel’s hometown; and to correct the cost of the licensing application fee.

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